Bharati Vidyapeeth Medical College.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Gadag Ischemic heart disease (IHD) is atherosclerotic narrowing of coronary arteries that is often asymptomatic early in the course of the disease but may lead to stable or unstable angina, and/or myocardial infarction with the progressive thickening or plaque rupture of the wall of the coronary arteries. Ischemic heart disease has now become one of the leading causes of death worldwide, accounting for more than 7.3 million deaths in 2008 alone. Microalbuminuria is a widely recognized, strong and independent risk marker of cardiovascular disease among individuals with diabetes, which as a marker of IHD in nondiabetics is currently under international debate.
In a cross-sectional study, 100 clinically diagnosed IHD patients were recruited, by using standard questionnaire demographic data, drug usage, disease history and physical examination were noted. Absence of diabetes mellitus was documented by no history of diabetes mellitus and evaluating serum blood glucose and HbA1c. Presence of microalbuminuria was confirmed by microalbumin quantitative estimation.
The mean age of the patients was 54.23 ± 14.44 years, ranging between 27 to 82 years. There was male predominance (84%) compared to females (16%). 51% of patients were smokers while 25% were alcoholics. Hypertension was reported to be the most prevalent comorbidity followed by Hyperhomocysteinemia and Hypothyroidism. The presence of microalbuminuria was found among 43 out of total 100 patients. Therefore, the incidence of microalbuminuria was 43%. There was no significant difference in the means of BSL, HbA1c and creatinine noted among the groups based on presence or absence of microalbuminuria. A significant positive association between presence of comorbidities and abnormal triglyceride level with presence of microalbuminuria was reported, while smoking status, alcoholic status and abnormal serum cholesterol level were not associated significantly with presence of microalbuminuria.
In the present study higher prevalence of microalbuminuria was reported among non-diabetic IHD patients, which might be caused due to presence of hypertension. Therefore, the present study recommends estimating urine microalbumin to identify high-risk individuals for IHD, for primary prevention of it.
加德干缺血性心脏病(IHD)是冠状动脉粥样硬化狭窄,疾病早期通常无症状,但可能导致稳定或不稳定型心绞痛和/或心肌梗死,随着冠状动脉壁的逐渐增厚或斑块破裂。缺血性心脏病现已成为全球主要死因之一,仅 2008 年就有超过 730 万人死亡。微量白蛋白尿是糖尿病患者心血管疾病的广泛认可的、强有力的独立危险因素标志物,作为非糖尿病患者 IHD 的标志物,目前正在国际上进行讨论。
在一项横断面研究中,招募了 100 名临床诊断为 IHD 的患者,通过使用标准问卷记录人口统计学数据、药物使用情况、病史和体格检查。通过无糖尿病病史和评估血清血糖和 HbA1c 来记录没有糖尿病。通过微量白蛋白定量估计来确认微量白蛋白尿的存在。
患者的平均年龄为 54.23 ± 14.44 岁,年龄在 27 至 82 岁之间。与女性(16%)相比,男性占优势(84%)。51%的患者吸烟,25%的患者酗酒。报告的最常见合并症是高血压,其次是高同型半胱氨酸血症和甲状腺功能减退症。在总共 100 名患者中,有 43 名患者存在微量白蛋白尿。因此,微量白蛋白尿的发生率为 43%。根据是否存在微量白蛋白尿,BSL、HbA1c 和肌酐的平均值在各组之间没有显著差异。报告称,合并症的存在和异常甘油三酯水平与微量白蛋白尿的存在之间存在显著的正相关,而吸烟状况、饮酒状况和异常血清胆固醇水平与微量白蛋白尿的存在无显著相关性。
在本研究中,非糖尿病性 IHD 患者中报告了更高的微量白蛋白尿患病率,这可能是由于高血压的存在。因此,本研究建议估计尿液微量白蛋白以识别 IHD 的高危个体,进行一级预防。